Comparison of Popliteal Nerve Block and Combined Spinal-Local Infiltration Anesthesia in Hallux Valgus Surgery: A Randomized Clinical Trial.

IF 1.3 4区 医学 Q2 Medicine
Leonieke N Palmen, Myrthe P F van de Ven, Elcke Karthaus, Martin Hagenaars, Sander Koëter, Justus H W Jansen
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Abstract

Background: Early mobilization and adequate pain relief are important in hallux valgus surgery. The effect of anesthesia technique on post-operative mobility has not been well studied.

Purpose: In search for the anesthesia technique that allows best for early mobility, a prospective clinical trial was conducted to compare popliteal nerve block anesthesia with combined local infiltration anesthesia (LIA) and spinal anesthesia.

Study design: Randomized clinical trial METHODS: Thirty-three patients eligible for hallux valgus surgery were prospectively randomized to receive either LIA/spinal anesthesia (n=14) or popliteal nerve block anesthesia (n=17). Hallux valgus surgery was performed in a short stay clinical setting, facilitating data collection during an overnight stay. Patients were postoperatively mobilized both on the day of surgery, and the next day. The primary outcome was early postoperative mobility. Intra- and postoperative pain relief, and patient satisfaction were secondary outcomes.

Results: On the day of surgery, independent mobilization and weight-bearing ability of patients who received LIA/spinal anesthesia were significantly better (p=0.022, p=0.010), compared to patients receiving the popliteal nerve block. The next day, independent mobilization did not differ between the 2 groups, although the weight bearing ability was better in patients who received LIA/spinal anesthesia. No significant between-group differences were observed in intra- and postoperative pain. High satisfaction with the anesthetic technique was achieved in both groups.

Conclusion: LIA/spinal anesthesia was associated with earlier independent ambulation and weight-bearing, suggesting potential benefits for outpatient hallux valgus surgery. However, both popliteal nerve block anesthesia and LIA/spinal anesthesia are suitable for hallux valgus surgery, with adequate pain relief and high patient satisfaction.

Level of clinical evidence: Level 2.

腘神经阻滞与脊髓-局部联合浸润麻醉在拇外翻手术中的比较:一项随机临床试验。
背景:在拇外翻手术中,早期活动和充分缓解疼痛是很重要的。麻醉技术对术后活动能力的影响尚未得到很好的研究。目的:为了寻找最有利于早期活动的麻醉技术,我们进行了一项前瞻性临床试验,比较腘神经阻滞麻醉与局部浸润麻醉(LIA)和脊髓联合麻醉。研究设计:随机临床试验方法:33例符合拇外翻手术条件的患者前瞻性随机接受LIA/脊髓麻醉(n=14)或腘神经阻滞麻醉(n=17)。拇外翻手术是在短期住院的临床环境中进行的,便于过夜住院期间的数据收集。术后患者在手术当天和第二天均可活动。主要结果是术后早期活动能力。术后疼痛缓解和患者满意度是次要结果。结果:手术当日,与腘神经阻滞组相比,LIA/脊髓麻醉组患者的独立活动能力和负重能力明显更好(p=0.022, p=0.010)。第二天,两组之间的独立活动没有差异,尽管接受LIA/脊髓麻醉的患者的负重能力更好。组内、术后疼痛无明显差异。两组患者对麻醉技术均有较高的满意度。结论:LIA/脊髓麻醉与早期独立行走和负重有关,提示门诊拇外翻手术的潜在益处。但腘神经阻滞麻醉和LIA/脊髓麻醉均适用于拇外翻手术,疼痛缓解效果好,患者满意度高。临床证据等级:2级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Foot & Ankle Surgery
Journal of Foot & Ankle Surgery ORTHOPEDICS-SURGERY
CiteScore
2.30
自引率
7.70%
发文量
234
审稿时长
29.8 weeks
期刊介绍: The Journal of Foot & Ankle Surgery is the leading source for original, clinically-focused articles on the surgical and medical management of the foot and ankle. Each bi-monthly, peer-reviewed issue addresses relevant topics to the profession, such as: adult reconstruction of the forefoot; adult reconstruction of the hindfoot and ankle; diabetes; medicine/rheumatology; pediatrics; research; sports medicine; trauma; and tumors.
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